TROPONIN IS INDEPENDENTLY ASSOCIATED WITH DEATH IN PATIENTS WITH COVID: A RETROSPECTIVE STUDY

Objective: We performed a single-centre retrospective observational study investigating the association between troponin positivity in patients hospitalised with COVID-19 and increased mortality in the short term. Methods: All adults admitted with swab-proven RT-PCR COVID-19 to Homerton University Hospital (HUH) from 04.02.20 to 30.04.20 were eligible for inclusion. We retrospectively analysed demographic and biochemical data collected from the physical and electronic patient records according to the primary outcome of death at 28 days during hospital admission. Troponin positivity was defined above the upper limit of normal according to our local laboratory assay (>15.5ng/l for females, >34 ng/l for males). Univariate and multivariate logistical regression analyses were performed to evaluate the link between troponin positivity and death. Results: Mean length of stay for all 402 hospitalised COVID-19 patients at HUH was 9.1 days (SD 12.0). Mean age was 65.3 years for men compared to 63.8 years for women. A chi-squared test showed that survival of COVID-19 patients was significantly higher in those with a negative troponin (p = 3.23 x10-10) compared to those with a positive troponin. In the multivariate logistical regression, lung disease, age, troponin positivity and CPAP were all significantly associated with death, with an AUC of 0.8872, sensitivity of 0.9004 and specificity of 0.6292 for the model. Within this model, troponin positivity was independently associated with short term mortality (OR 3.23, 95% CI 1.53-7.16, p=0.00278). Conclusions: We demonstrated an independent association between troponin positivity and increased short-term mortality in COVID-19 in a London district general hospital.

Obesity Facts and Their Influence on Renal Function Across the Life Span

Obesity is a chronic disease, with a rapidly increasing prevalence worldwide. Body mass index (BMI) provides the most useful population-level measure of overweight and obesity. For adults, overweight is defined as a BMI (Kg/m2) ≥ 25, and obesity as a BMI ≥ 30, for non-Asians and ≥ 27.5 for Asians. Abdominal obesity can be defined as a waist circumference equal to or higher than 102 cm for men and ≥88 cm for women. The definition of children and adolescents BMI changes with age and sex. Obesity may be exogenous or endogenous obesity, the latter is multifactorial and predominantly manifested during childhood. Presently, overweight and obesity are linked to more deaths worldwide than underweight. The total kidney glomerular filtration rate (GFR) is determined by the sum of nephrons and the GFR within each nephron or single nephron GFR. In clinical practice, GFR is more frequently calculated by GFR estimating equations based upon the plasma levels of creatinine, cystatin C, or both. The measured value of plasma creatinine is strongly influenced by non-GFR factors, by its tubular and gastrointestinal secretion, and by the problems associated with the lack of standardization of creatinine's laboratory assay discrediting it as an ideal GFR biomarker. Unlike creatinine, cystatin C plasma levels are mainly determined by GFR. Obesity may affect the kidney, via development of systemic arterial hypertension and/or diabetes mellitus, or directly, by ectopic accumulation of adipose tissue in the kidney. As obesity is a clinical condition associated with altered body composition, creatinine may not be the ideal biomarker for GFR measurement in obese individuals.

Diagnosis and Treatment of Bacterial Pneumonia in Critically Ill Patients with COVID-19 Using a Multiplex PCR Assay: A Large Italian Hospital’s Five-Month Experience

Since bacterial pneumonia is relatively frequent, suspicion of it in COVID-19 patients may prompt ICU clinicians to overuse (broad-spectrum) antibiotics, particularly when empirical antibiotics do not cover the suspected pathogen. We showed that a PCR-based, culture-independent laboratory assay allows not only accurate diagnosis but also streamlining of antimicrobial therapy for bacterial pneumonia episodes.

Biocontrol potential of entomopathogenic fungi, nematodes and bacteria against Rhynchophorus ferrugineus (Olivier)

Background The red palm weevil (RPW), Rhynchophorus ferrugineus (Olivier) (Coleoptera: Curculionidae), is a serious threat to date palms across the globe, causing heavy yield losses. The pest inflicts damage to palms stem and destroys vascular system; resultantly lower the vigor and affect the growth and yield. For ecological farming system, biological control of the pest is gaining increased interest due to hosts’ specificity, safety to human, animal and non-target organisms, and their compatibility to environment. Results In laboratory assay, Beauveria bassiana, Heterorhabditis bacteriophora and Bacillus thuringiensis var. kurstaki (Bt-k) alone and in combination against sixth instar larvae and adults of four distinct populations of RPW were applied. H. bacteriophora was more effective, followed by B. bassiana and Bt-k in alone treatments. While in combined treatments, the highest mortality was recorded for H. bacteriophora + B. bassiana combination (100% for both stages), followed by H. bacteriophora + Bt-k, (larvae 100%; adults 94.24%) and B. bassiana + Bt-k treatments (larvae: 87.01%; adults: 80.53%). Maximum rate of mycosis (larvae 85.74%; adults 69.07%), sporulation (larvae 189.22 conidia ml−1; adults 164.56 conidia ml−1), cadavers affected by nematodes (larvae 92.4%; adults 81.29%) and nematode production (larvae 178.78 IJs ml−1; adults 153.44 IJs ml−1) was observed where B. bassiana or H. bacteriophora was applied alone and the lowest (larvae 122.78 IJs ml−1; adults: 103.22 IJs ml−1) was recorded for H. bacteriophora + B. bassiana combination. Conclusions Entomopathogens can be effectively used alone and/or in integration to control RPW populations. Natural capability of entomopathogens to infect and disseminate into other hosts makes them excellent biocontrol agents to be incorporated in the IPM plan of RPW and to make palm growers confident with the use of the most promising microbial control agents.

Significance of NPM1 Gene Mutations in AML

The aim of this literature review is to examine the significance of the nucleophosmin 1 (NPM1) gene in acute myeloid leukaemia (AML). This will include analysis of the structure and normal cellular function of NPM1, the type of mutations commonly witnessed in NPM1, and the mechanism by which this influences the development and progression of AML. The importance of NPM1 mutation on prognosis and the treatment options available to patients will also be reviewed along with current guidelines recommending the rapid return of NPM1 mutational screening results and the importance of employing a suitable laboratory assay to achieve this. Finally, future developments in the field including research into new therapies targeting NPM1 mutated AML are considered.

Rapid and Laboratory SARS-CoV-2 Antibody Testing in High-Risk Hospital Associated Cohorts of Unknown COVID-19 Exposure, a Validation and Epidemiological Study After the First Wave of the Pandemic

Objective: We aimed to use SARS-CoV-2 antibody tests to assess the asymptomatic seroprevalence of individuals in high-risk hospital cohorts who's previous COVID-19 exposure is unknown; staff, and patients requiring haemodialysis or chemotherapy after the first wave.Methods: In a single Center, study participants had five SARS-CoV-2 antibody tests done simultaneously; one rapid diagnostic test (RDT) (Superbio Colloidal Gold IgM/IgG), and four laboratory tests (Roche Elecsys® Anti-SARS-CoV-2 IgG [RE], Abbott Architect i2000SR IgG [AAr], Abbott Alinity IgG [AAl], and Abbott Architect IgM CMIA). To determine seroprevalence, only positive test results on laboratory assay were considered true positives.Results: There were 157 participants, of whom 103 (65.6%) were female with a median age of 50 years (range 19–90). The IgG component of the RDT showed a high number of false positives (n = 18), was inferior to the laboratory assays (p < 0.001 RDT vs. AAl/AAr, p < 0.001 RDT vs. RE), and had reduced specificity (85.5% vs. AAl/AAr, 87.2% vs. RE). Sero-concordance was 97.5% between IgG laboratory assays (RE vs. AAl/AAr). Specificity of the IgM component of the RDT compared to Abbott IgM CMIA was 95.4%. Ten participants had positivity in at least one laboratory assay, seven (9.9%) of which were seen in HCWs. Two (4.1%) hematology/oncology (H/O) patients and a single (2.7%) haemodialysis (HD) were asymptomatically seropositive. Asymptomatic seroprevalence of HCWs compared to patients was not significant (p = 0.105).Conclusion: HCWs (9.9%) had higher, although non-significant asymptomatic seroprevalence of SARS-CoV-2 antibodies compared to high-risk patients (H/O 4.1%, HD 2.7%). An IgM/IgG rapid diagnostic test was inferior to laboratory assays. Sero-concordance of 97.5% was found between IgG laboratory assays, RE vs. AAl/AAr.

Studies on the Prevalence and Etiology of Pelvic Inflammatory Disease Among Women Attending Primary Health Centers in Sokoto Metropolis

Pelvic Inflammatory Disease (PID) is an inflammation of the uterus, fallopian tube, and ovaries as it progresses to scar leading to infertility and other reproductive problems. This research work was conducted to determine the etiology, antibiogram and prevalence of pelvic inflammatory disease among women attending Public Health Centres in Sokoto metropolis. The main objective of the study is to isolate the pathogens and determine the antibiotics sensitivity pattern and prevalence age of the Disease among the patients diagnosed with PID. 155 PID patients that were sorted by age and month were diagnosed within the year 2020. Laboratory assay on the etiology and antibiogram were carried out. From the total (155) patients diagnosed with PID in this study, thirty-three (33) were within the age of 15-20, forty-one (41) were between the ages of 21-25 and fifty-five (55) were between the age ranges of 26-30. The least (26) were between ages of 36 and 40. The highest prevalence age (35.5%) in this study were observed to fall between the ages of 26-30 then followed by forty-one patients (26.5%) prevalence that were between the ages of 21-25. The least in occurrence were 26 patients (8.4%) that were between the age range of 36 and 40. Similarly, the results obtained from this study revealed that there were 77 (49.67%) recorded in the first quarter of the year 2020. This was then followed by 48 (30.97%) patients in the last quarter. The least occurrence of PID patients 30 (19.35%) were diagnosed in the second quarter of the same year. The pathogens consistently identified to be associated with the disease were Neisseria gonorrhea and ciprofloxacin was the most sensitive on antibiogram. The factors responsible were poor personal hygiene, environmental pollution and unsanitary conditions of the toilets. It is recommended that patients should regularly visit health facilities for routine diagnosis of PID and ciprofloxacin and Broad spectrum antibiotics were the most efficacious for use in this study in the treatment of Pelvic inflammatory Disease.

Why Plants Harbor Complex Endophytic Fungal Communities: Insights From Perennial Bunchgrass Stipagrostis sabulicola in the Namib Sand Sea

All perennial plants harbor diverse endophytic fungal communities, but why they tolerate these complex asymptomatic symbioses is unknown. Using a multi-pronged approach, we conclusively found that a dryland grass supports endophyte communities comprised predominantly of latent saprophytes that can enhance localized nutrient recycling after senescence. A perennial bunchgrass, Stipagrostis sabulicola, which persists along a gradient of extreme abiotic stress in the hyper-arid Namib Sand Sea, was the focal point of our study. Living tillers yielded 20 fungal endophyte taxa, 80% of which decomposed host litter during a 28-day laboratory decomposition assay. During a 6-month field experiment, tillers with endophytes decomposed twice as fast as sterilized tillers, consistent with the laboratory assay. Furthermore, profiling the community active during decomposition using next-generation sequencing revealed that 59–70% of the S. sabulicola endophyte community is comprised of latent saprophytes, and these dual-niche fungi still constitute a large proportion (58–62%) of the litter community more than a year after senescence. This study provides multiple lines of evidence that the fungal communities that initiate decomposition of standing litter develop in living plants, thus providing a plausible explanation for why plants harbor complex endophyte communities. Using frequent overnight non-rainfall moisture events (fog, dew, high humidity), these latent saprophytes can initiate decomposition of standing litter immediately after tiller senescence, thus maximizing the likelihood that plant-bound nutrients are recycled in situ and contribute to the nutrient island effect that is prevalent in drylands.

Recalibration of the Antimicrobial MIC

In 2009, the World health organization (WHO) referred to the problem of antibiotics and antibiotic resistance stating, “Antibiotic Resistance – one of the three greatest threats to human health.” In 2019 (i.e., just as the COVID-19 pandemic was evolving), more than 2.8 million antibiotic-resistant infections were identified in the United States, resulting in more than 35,000 deaths (CDC 2019). The initial laboratory assay which demonstrated the activity of an antibacterial compound was performed by Alexander Fleming. He showed that an extract from the mold, Penicillium rubens, could inhibit the growth of several species of Gram-positive bacteria – but not Gram-negative bacteria that were cross-streaked on agar against the diffused Penicillium compound.